OBJECTIVES: To study the resuscitation preferences, choice of decision-maker, views on the seeking of patients' wishes and determinants of these of elderly hospital in-patients. DESIGN: Questionnaire administered on admission and prior to discharge. SETTING: Two acute geriatric medicine units (Southampton and Poole). PARTICIPANTS: Two hundred and fourteen consecutive consenting mentally competent patients admitted to hospital as emergencies. RESULTS: Resuscitation was wanted by 60%, particularly married and functionally independent patients and those who had not already considered it. Not wanted resuscitation was (...) associated with lack of social contacts. Sixty-seven per cent welcomed enquiry about their preferences and 78% wanted participation in decision, 43% as sole decision-maker. Wishing to choose oneself was associated with not wanting resuscitation, prior knowledge of it, and lack of a spouse. Patients' opinions remained stable during their admission. CONCLUSIONS: Discussion of resuscitation is practical on hospital admission without causing distress and the views expressed endure through the period of hospitalisation. Elderly patients' attitudes depend partly on personal health and social circumstances. This may assist doctors when patients are unable to participate themselves. (shrink)

Most lymphocytes of the T cell lineage develop along the CD4/CD8 pathway and express antigen receptors on their surfaces consisting of clonotypic αβ chains associated with invariant CD3‐γδε components and ζ chains, collectively referred to as the T cell antigen receptor complex (TCR). Expression of the TCR complex is dynamically regulated during T cell development, with immature CD4+CD8+ thymocytes expressing only 10% of the number of αβ TCR complexes on their surfaces expressed by mature CD4+ and CD8+ T cells. Recent (...) evidence demonstrates that low surface TCR density on CD4+CD8+ thymocytes results from the limited survival of a single TCR component within the ER, the TCRα chain, which has a half life of only 15 minutes in immature thymocytes, compared to >75 minutes in mature T cells. Instability of TCRα proteins in immature CD4+CD8+ thymocytes represents a novel mechanism by which expression of the multisubunit TCR complex is quantitatively regulated during T cell development. In the current review we discuss our recent findings concerning the assembly, intracellular transport, and expression of αβ TCR complexes in CD4+CD8+ thymocytes and comment on the functional significance of TCRα instability during T cell development. (shrink)

Nanomedicine is yielding new and improved treatments and diagnostics for a range of diseases and disorders. Nanomedicine applications incorporate materials and components with nanoscale dimensions where novel physiochemical properties emerge as a result of size-dependent phenomena and high surface-to-mass ratio. Nanotherapeutics and in vivo nanodiagnostics are a subset of nanomedicine products that enter the human body. These include drugs, biological products, implantable medical devices, and combination products that are designed to function in the body in ways unachievable at larger scales. (...) Nanotherapeutics andin vivonanodiagnostics incorporate materials that are engineered at the nanoscale to express novel properties that are medicinally useful. These nanomedicine applications can also contain nanomaterials that are biologically active, producing interactions that depend on biological triggers. Examples include nanoscale formulations of insoluble drugs to improve bioavailability and pharmacokinetics, drugs encapsulated in hollow nanoparticles with the ability to target and cross cellular and tissue membranes and to release their payload at a specific time or location, imaging agents that demonstrate novel optical properties to aid in locating micrometastases, and antimicrobial and drug-eluting components or coatings of implantable medical devices such as stents. (shrink)

Important features of the self-concept can be located outside of the individual and inside close or related others. The authors use this insight to reinterpret data previously said to support the empathy-altruism model of helping, which asserts that empathic concern for another results in selflessness and true altruism. That is, they argue that the conditions that lead to empathic concern also lead to a greater sense of self-other overlap, raising the possibility that helping under these conditions is not selfless but (...) is also directed toward the self. In 3 studies, the impact of empathic concern on willingness to help was eliminated when oneness--a measure of perceived self-other overlap--was considered. Path analyses revealed further that empathic concern increased helping only through its relation to perceived oneness, thereby throwing the empathy-altruism model into question. The authors suggest that empathic concern affects helping primarily as an emotional signal of oneness. (shrink)

(1979). Some Observations on the Problems of Grading Examinations with Several Components: a reply to P. J. Squire. Educational Studies: Vol. 5, No. 3, pp. 225-230.

Research on social influences often distinguishes between social and quality incentives to ascribe meaning to the value that popularity conveys. This study examines the neural correlates of those incentives through which popularity influences preferences. This research reports an functional magnetic resonance imaging experiment and a behavioral task in which respondents evaluated popular products with three focus perspectives; unspecified focus, focus on social aspects, and focus on quality. The results show that value derived with a social focus reflects inferences of approval (...) and reward value, and positively affects preferences. Value derived with a quality focus reflects inferences of quality and negatively affects preferences. This study provides evidence of two distinct inferential routes on both a neurological level, represented by different regions in the brain, and a behavioral level. These results provide the first evidence that a single popularity cue can in different ways influence the value derived from product popularity. (shrink)

Abstract. We argue that all human beings have a special type of dignity which is the basis for (1) the obligation all of us have not to kill them, (2) the obligation to take their well-being into account when we act, and (3) even the obligation to treat them as we would have them treat us, and indeed, that all human beings are equal in fundamental dignity. We give reasons to oppose the position that only some human beings, because of (...) their possession of certain characteristics in addition to their humanity (for example, an immediately exercisable capacity for self-consciousness, or for rational deliberation), have full moral worth. What distinguishes human beings from other animals, what makes human beings persons rather than things, is their rational nature, and human beings are rational creatures by virtue of possessing natural capacities for conceptual thought, deliberation, and free choice, that is, the natural capacity to shape their own lives. (shrink)

With this issue we initiate the policy of expanding the scope of Tulane Studies in Philosophy to include, in addition to the work of members of the department, contributions from philosophers who have earned advanced degrees from Tulane and who are now teaching in other colleges and universities. The Editor THE LOGIC OF OUR LANGUAGE ROBERT L. ARRINGTON Wittgenstein wrote in the Tractatus that "logic is not a body of doctrine, but a mirror-image of the world. " 1 In (...) line with his suggestion that a proposition is a 'picture', Wittgenstein argued that propositions 'show' the logical structure of the real. He was insistent, however, that "the apparent logical form of a proposition need not be its real one. " 2 As a result of this we can misunderstand the structure of fact. Philosophical problems arise just when "the logic of our language is mis understood. " 3 It is common knowledge that much of this view of logic was rejected by Wittgenstein himself in the Philosophical Investi gations. There we are told that language has no ideal or sublime 4 logic which mirrors the structure of the extra-linguistic world. Consequently, inferences from the structure of language to the structure of that extra-linguistic world are invalid. Reality can be 'cut up' in any of a number of ways by language. Wittgenstein adopted a view of philosophy which would render that discipline a non-explanatory, non-critical study of the multiple ways in which language can be used. (shrink)

Epidemiology is a core science of public health, focusing on research related to the distribution and determinants of both positive and adverse health states and events and on application of knowledge gained to improve public health. The American College of Epidemiology (ACE) is a professional organization devoted to the professional practice of epidemiology. As part of that commitment, and in response to concerns for more explicit attention to core values and duties of epidemiologists in light of emerging issues and increased (...) scrutiny of epidemiology, the College developed, adopted, and published a set of Ethics Guidelines. The structure of the ACE ethics guidelines is in four parts: (1) a brief statement of core values and duties of epidemiologists, coupled with the virtues important to professional practice; (2) concise statements of key duties and obligations; (3) exposition of the duties and obligations with more applications; and (4) a brief summary and conclusion. The Guidelines have been published on the ACE website and in the official College journal Annals of Epidemiology. The guidelines contain (and maintain) core elements that define the discipline of epidemiology and its fundamental duties, but they are also intended to be dynamic and evolving, responsive to a changing professional and social environment. (shrink)

Prevailing theories of the neural basis of at least a subset of individuals with autism spectrum disorder include an imbalance of excitatory and inhibitory neurotransmission. These circuitry imbalances are commonly probed in adults using auditory steady-state responses to elicit coherent electrophysiological responses from intact circuitry. Challenges to the ASSR methodology occur during development, where the optimal ASSR driving frequency may be unknown. An alternative approach is the amplitude-modulated sweep in which the amplitude of a tone is modulated as a sweep (...) from 10 to 100 Hz over the course of ∼15 s. Phase synchrony of evoked responses, measured via intra-trial coherence, is recorded as a function of frequency. We applied such AM sweep stimuli bilaterally to 40 typically developing and 80 children with ASD, aged 6–18 years. Diagnoses were confirmed by DSM-5 criteria as well as autism diagnostic observation schedule observational assessment. Stimuli were presented binaurally during MEG recording and consisted of 20 AM swept stimuli with a duration of ∼30 s each. Peak intra-trial coherence values and peak response frequencies of source modeled responses were examined. First, the phase synchrony or inter-trial coherence of the ASSR is diminished in ASD; second, hemispheric bias in the ASSR, observed in typical development, is maintained in ASD, and third, that the frequency at which the peak response is obtained varies on an individual basis, in part dependent on age, and with altered developmental trajectories in ASD vs. TD. Finally, there appears an association between auditory steady-state phase synchrony and clinical assessment of language ability/impairment. We concluded that the AM sweep stimulus provides a mechanism for probing ASSR in an unbiased fashion, during developmental maturation of peak response frequency, peak frequencies vary, in part due to developmental age, and importantly, ITC at this peak frequency is diminished in ASD, with the degree of ITC disturbance related to clinically assessed language impairment. (shrink)

The COVID-19 pandemic has raised a host of ethical challenges, but key among these has been the possibility that health care systems might need to ration scarce critical care resources. Rationing p...

The negative emotions generated following stressful life events can increase one’s risk of depressive symptoms and promote higher levels of perceived stress. The process model of emotion regulation can help distinguish between adaptive and maladaptive emotion regulation strategies to determine who may be at the greatest risk of worse psychological health across the lifespan. Heart rate variability may affect these relationships as it indexes aspects of self-regulation, including emotion and behavioral regulation, that enable an individual to dynamically adapt to the (...) changing demands of both internal and external environments. In this study, we expected individual differences in resting vagally mediated HRV to moderate the influence of emotion regulatory strategies among our sample of 267 adults. We found support for the hypothesis that higher vagally mediated HRV buffers against the typical adverse effects of expressive suppression when evaluating depressive symptoms and found weak support when considering perceived stress. There was no evidence for an interaction between cognitive reappraisal and vagally mediated HRV but there was a significant, negative association between cognitive reappraisal and depressive symptoms and perceived stress. Future work may determine if intervening on either emotion regulation strategies or HRV may change these within-persons over time. (shrink)

This compact and innovative book tackles one of the central issues in drug policy: the lack of a coherent conceptual structure for thinking about drugs. Drugs generally fall into one of seven categories: prescription, over the counter, alternative medicine, common-use drugs like alcohol, tobacco and caffeine; religious-use, sports enhancement; and of course illegal street drugs like cocaine and marijuana. Our thinking and policies varies wildly from one to the other, with inconsistencies that derive more from cultural and social values than (...) from medical or scientific facts. Penalties exist for steroid use, while herbal remedies or cold medication are legal. Native Americans may legally use peyote, but others may not. Penalties may vary for using different forms of the same drug, such as crack vs. powder cocaine. Herbal remedies are unregulated by the FDA; but medical marijuana is illegal in most states. Battin and her contributors lay a foundation for a wiser drug policy by promoting consistency and coherency in the discussion of drug issues and by encouraging a unique dialogue across disciplines. The contributors are an interdisciplinary group of scholars mostly based at the University of Utah, and include a pharmacologist, a psychiatrist, a toxicologist, a trial court judge, a law professor, an attorney, a diatary specialist, a physician, a health expert on substance abuse, and Battin herself who is a philosopher. They consider questions like the historical development of current policy and the rationales for it; scientific views on how drugs actually cause harm; how to define the key notions of harm and addiction; and ways in which drug policy can be made more consistent. They conclude with an examination of the implications of a consistent policy for various disciplines and society generally. The book is written accessibly with little need for expert knowledge, and will appeal to a diverse audience of philosophers, bioethicists, clinicians, policy makers, law enforcement, legal scholars and practitioners, social workers, and general readers, as well as to students in areas like pharmacy, medicine, law, nursing, sociology, social work, psychology, and bioethics. (shrink)

The paper by Magill and Neaves in this issue of the Journal attempts to rebut the "natural potency" position, based on recent advances in direct reprogramming of somatic cells to yield "induced pluripotent stem" (iPS) cells. As stated by the authors, the natural potency position holds that because "a human embryo directs its own integral organismic function from its beginning . . . there is a whole, albeit immature, and distinct human organism that is intrinsically valuable with the status of (...) inviolability and deserving full moral respect" (p. 26). The authors boldly assert that "The recent production of iPS . . . highlights a prima facie absurdity for the natural potentiality argument" (p. 29). Yet the argument against natural potency is both logically flawed and based on a characterization of the scientific evidence that is factually inaccurate. (shrink)

Hertwig and Ortmann suggest methodological practices from economics (script enactment, repeated measures, performance based payments, and absence of deception) for psychology. Such prescriptive methodologies may be unrepresentative of real world behaviors because people are not: always behaving with complete information, monetarily rewarded for important activities, repeating tasks to perfection, aware of all contributing variables. These proscriptions, while useful in economics, may obfuscate important psychological phenomena.

For the first time in English the world community of scholars is systematically assembling and presenting the results of recent research in the vast literature of Soren Kierkegaard. Based on the definitive English edition of Kierkegaard's works by Princeton University Press, this series of commentaries addresses all the published texts of the influential Danish philosopher and theologian.

The nature of measurement is a topic of central concern in the philosophy of science and, indeed, measurement is the essential link between science and mathematics. Professor Ellis's book, originally published in 1966, is the first general exposition of the philosophical and logical principles involved in measurement since N. R. Campbell's Principles of Measurement and Calculation, and P. W. Bridgman's Dimensional Analysis. Professor Ellis writes from an empiricist standpoint. His object is to distinguish and define the basic concepts in measurement, (...) for example: scale, quantity, unit. dimension, number and probability. He discusses the problem of classifying scales of measurement and the special logical problems associated with each kind of scale. A translation of mach's Critique on the Concept of Temperature, which gives his views on the nature of measurement more fully than in any of his other works, is given as an appendix. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:THE INCARNATION: MUSLIM OBJECTIONS AND THE CHRISTIAN RESPONSE ROBERT L. FASTIGGI St. Edward's University Austin, Texas Introduction: Christian-Muslim Dialogue and the Incarnation THE TWO largest religions in the world, Christianity and Islam cannot help but encounter each other. In the last two decades, several important steps have been made by Catholics, Protestants and Orthodox Christians to engage in meaningful dialogue with members of the Islamic faith.1 While sincerity, (...) mutual respect and good will are all in evidence in these efforts to dialogue, it also is clear that an authentic theological discussion between Christians and Muslims cannot help but arouse a certain degree of tension over the Christian doctrine of the Incarnation. In my own experience in dialogue with Muslims,2 there seems to emerge a point in which discussion of Jesus the prophet vs. Jesus the Incarnate Word of God will inevitably take place. Such discussions can prove to be stimulating and educational. However, they tend to go best when there is an honest and open acknowledgement of the differences that exist between 1 A good summary of Catholic and Protestant efforts can be found in John Renard, " Christian-Muslim Dialogue: A Review of Six Post-Vatican II, Church-Related Documents," Journal of Ecunmenical Studies 23 :1, Winter, 1986: 69-89. On the Orthodox Christian dialogue with Muslims, see Orthodox Christians and Muslims, ed. N. M. Vaporis (Brookline, Mass.: Holy Cross Orthodox Press, 1986). 2 I have visited Saudi Arabia and Bahrain as a Joseph J. Malone Fellow with the National Council of U.S.-Arab Relations, and I was a member of the Christian-Muslim Dialogue Commission of the Austin Metropolitan Ministries in Austin, Texas. 457 458 ROBERT L. FASTIGGI the two traditions. As Georges Anawati, a Catholic Islamicist; notes : " As a starting point, dialogue requires respect for the identity of the other. It does not ignore obvious differences... for to do so would be of no use for ·either friendship or truth." 3 A Muslim scholar, Professor Mohammed Taibi of the University of Tunis, likewise remarks that " the more one is firm about the classical aspects of divergence, the better the contacts between Christians and Muslims." 4 At issue in the Christian-Muslim discussion of the Incarnation is the unique character of each faith. In Islam, there is the absolute affirmation of divine unity (tawhid) which necessarily condemns any attempt to associate something other than God with God (shirk). Christianity, though, has as one of its central tenets the affirmation that the uncreated Word of God (ho logos) became flesh (sarx) in Jesus (John 1 :14). Islam, therefore, presents a unique challenge to the Christian theologian. Is it possible to formulate a Christology which can affirm the Islamic principle of tawhid and evade the accusation of shirk without compromising the core of the Christian message? This is the question this article hopes to address. One suggestion for Christians in dialogue with Muslims is given by Hans Kiing in his book Christianity and the World Religions.5 Kiing believes that Christians would do best to go back to the mindset of the original Jewish Christians who possessed an understanding of Jesus which is much more compatible with the Qur'anic view of Jesus as the "servant of God." 6 While Kiing's suggestion is helpful for Christians who are looking for an analogy to the Islamic view of Jesus, I find it problematical for several reasons. Kiing seems to suggest that the Jesus of history (as s Georges Anawati, 0.P., "An Assessment of the Christian-Islamic Dialogue," in The Vatican, Islam and the Middle East, ed. Kail Ellis, O.S.A. (Syracuse, N.Y.: Syracuse University Press, 1987), p. 59. 4 Ibid., p. 65. 5 Hans Kung, Christi"anity and the World Religions: Paths of Dialogue with Islam, Hinduism, and Buddhism, trans. Peter Heinegg (New York: Doubleday, 1986), pp. 109-130. a Ibid., p. 122. MUSLIM OBJECTIONS & CHRISTIAN RESPONSE 459 well as the Jesus of the New Testament) is quite separate from the Christ of the ecumenical councils. Such an assertion, though, does not find support from many Christian theologians and biblical scholars (not to mention church authorities).1 Moreover, Kiing appears to have an... (shrink)

J. L. Schellenberg claims that the weakness of evidence for God’s existence is not merely a sign that God is hidden, “it is a revelation that God does not exist.” In Divine Hiddenness : New Essays, Michael J. Murray provides a “soul-making” defense of God’s hiddenness, arguing that if God were not hidden, then some of us would lose what many theists deem a good thing: the ability to develop morally significant characters. In this paper, I argue that Murray’s soul-making (...) defense not only fails to defend God’s hiddenness, it produces an argument for the nonexistence of God. (shrink)